Relative risk of anxiety and depression among COVID-19 survivor healthcare workers from a tertiary care hospital in Pakistan: A pilot cohort study

Longitudinal studies for determining the risk of anxiety and depression among COVID-19 survivor healthcare workers are lacking. This study aimed to determine the risk of anxiety and depression among healthcare workers that survived COVID-19 infection through a six-month post-recovery follow-up. This was a cohort study conducted at the Department of Obstetrics and Gynecology, Lady Reading Hospital, Peshawar, from 1st March to 30th August 2020. A total of 64 subjects participated. Hospital Anxiety and Depression Scale (HADS) was used for assessing the anxiety and depression symptoms. HADS has three score cutoff as normal, borderline abnormal and, abnormal anxiety/depression. For the purpose of the study, borderline and above scores were taken as positive for anxiety/depression. Data was analysed using STATA Corp 15.1. There was no increased risk of anxiety or depression six months post-COVID-19 infection in the infected HCW, compared to uninfected HCW. It is recommended to conduct longitudinal studies with large sample and longer follow-up

Academic performance in adolescent students: The role of parenting styles and socio-demographic factors – a cross sectional study from Peshawar, Pakistan

Academic performance is among the several components of academic success. Many factors, including socioeconomic status, student temperament and motivation, peer, and parental support influence academic performance. Our study aims to investigate the determinants of academic performance with emphasis on the role of parental styles in adolescent students in Peshawar, Pakistan. A total of 456 students from 4 public and 4 private schools were interviewed. Academic performance was assessed based on self-reported grades in the latest internal examinations. Parenting styles were assessed through the administration of the Parental Bonding Instrument (PBI). Regression analysis was conducted to assess the influence of socio-demographic factors and parenting styles on academic performance. Factors associated with and differences between care and overprotection scores of fathers and mothers were analyzed. Higher socio-economic status, father\u27s education level, and higher care scores were independently associated with better academic performance in adolescent students. Affectionless control was the most common parenting style for fathers and mothers. When adapted by the father, it was also the only parenting style independently improving academic performance. Overall, mean care scores were higher for mothers and mean overprotection scores were higher for fathers. Parenting workshops and school activities emphasizing the involvement of mothers and fathers in the parenting of adolescent students might have a positive influence on their academic performance. Affectionless control may be associated with improved academics but the emotional and psychosocial effects of this style of parenting need to be investigated before recommendations are made

The Impact of COVID-19 Pandemic on Final Year Medical Students: Single Center Study

Introduction: The COVID-19 health emergency led to adoption of unprecedented measures that have never been seen in recent times. The study examines the effect of COVID-19 on final year medical students’ final professional examination preparedness, transition to house job and earlier assistantship.Methodology: This descriptive cross-sectional survey was conducted in September – October 2020 after institutional review board approval at University College of Medicine and Dentistry (UCMD) in Lahore, Pakistan. A total of 112 final year medical students responded to this survey whereas 13 did not. Data was analyzed using SPSS 25. Chi square test was applied to evaluate the impact of COVID 19 on variables of interest (p-value< 0.05 considered significant). Results: Postponement of clinical rotations, written exams, OSPEs and clinical ward tests was reported by 62%, 78%, 71% and 48% students respectively whilst 29%, 13%, 18% and 21% students respectively stated it to be formatted. A statistically significant impact (p<0.05) was observed for final professional examinations preparedness and confidence to assist earlier.Conclusion: The study demonstrated the significant impact of COVID-19 on final year medical students’ examination preparedness and confidence to assist earlier in hospital. Improvised teaching methodology is urgently needed to fill in the lapses in their education.Keywords: COVID-19, Medical Education, Final year MBBS professional examination, OSPE, Earlier Assistantship, House Job

Heat emergencies: Perceptions and practices of community members and emergency department healthcare providers in Karachi, Pakistan: A qualitative study

Heat waves are the second leading cause of weather-related morbidity and mortality affecting millions of individuals globally, every year. The aim of this study was to understand the perceptions and practices of community residents and healthcare professionals with respect to identification and treatment of heat emergencies. A qualitative study was conducted using focus group discussions and in-depth interviews, with the residents of an urban squatter settlement, community health workers, and physicians and nurses working in the emergency departments of three local hospitals in Karachi. Data was analyzed using content analysis. The themes that emerged were (1) perceptions of the community on heat emergencies; (2) recognition and early treatment at home; (3) access and quality of care in the hospital; (4) recognition and treatment at the health facility; (5) facility level plan; (6) training. Community members were able to recognize dehydration as a heat emergency. Males, elderly, and school-going children were considered at high risk for heat emergencies. The timely treatment of heat emergencies was widely linked with availability of financial resources. Limited availability of water, electricity, and open public spaces were identified as risk factors for heat emergencies. Home based remedies were reported as the preferred practice for treatment by community members. Both community members and healthcare professionals were cognizant of recognizing heat related emergencies

Epidemiology and perceptions of non-fatal burns among select youth (15–24 years old) from Peshawar Pakistan; a sequential explanatory mixed methods study

Purpose: Burns are among the top five cause of unintentional injuries among youth. We aimed to determine the incidence and risk factors of burns in select youth from Pakistan and also explored their perceptions about burns. Methods: A sequential explanatory mixed methods study was conducted which comprised of two phases. Phase 1 consisted of a cross-sectional quantitative survey (QUAN) in which 550 vocational school youth (15 to 24 years-olds) filled out the WHO community survey tool for injuries and violence and provided data on burns in previous 12 months (2021–22). Phase 2 consisted of qualitative (QUAL), in-depth interviews (IDIs) with participants selected from Phase 1 based on the occurrence of burns. STATA™ version 15.1 was used for Phase 1 data analysis and Zero-Inflated Negative Binomial regression was used for determining the Incidence Rate Ratio (IRR) of burns. Thematic analysis was performed for in-depth interviews from Phase 2. Results: Out of 547 participants, 356 (65%) were males while 191 (35%) were females. Burns were reported by 85 participants (15%). A total of 137 counts of burns were reported showing multiple burns by some participants. The IRR for burns among young females was 2.89 (1.78–4.69) compared to males in the previous 12 months (2021–22). Age, sex, father’s education, and combined family income were significant risk factors for burns in youth. Six IDIs were conducted with burn victims, two were males while six were females. Four cooking-related burns, and two occupational burns during vocational training were reported. Themes that emerged from IDIs were internal and external factors, personal carelessness and lack of knowledge and safety about burns. Two sub-themes that were significant for recovery from burns were family support and access to healthcare. Conclusion: Young females are at a higher risk of burn injuries in Pakistan. Various social, demographic, and behavioral risk factors are associated with burns. Pre-burn and post-burn interventions are needed for prevention from burns in youth

Parental knowledge attitude and practices about chemical and medicinal poisons: A hospital based study from Karachi, Pakistan

Background: Unintentional poisoning is among the leading cause of death in children less than 20 years age. The incidence of unintentional poisoning in Low-income countries LMICs is four times higher compared to high-income countries (HICs). In Pakistan a 10% (25/211) incidence of unintentional poisonings among 0-15-year-old children has been reported. Most of the poisoning occur because of household chemical and medicines. This study aimed to assess the knowledge, attitude, and practices (KAP) of parents in Karachi regarding poisonous household chemicals and medicines.Methods: This KAP study was conducted at Aga Khan University Hospital, Karachi from May to August 2019. A maximum sample of 384 was calculated using a 50% knowledge about household chemicals. Data were collected about parental knowledge, attitude and practices about poisons and chemicals at home and presented as frequency and percentages. Chi-square test of independence (or Fisher\u27s exact test) was used. Data were analyzed using SPSS version 20.Results: A total of 364 parents of 0-16-year-old children completed the survey out of which 229 were mothers and 127 were fathers (eight had missing data). We had 70% of parents that kept chemicals and medicines locked in cabinets and 80% chose to never leave medicines unattended, there are still 20-30% parents that need improvement in the parental knowledge and practices for storing chemicals and medicines. A general lack of knowledge regarding poisoning first aid and emergency response centers was noted.Conclusions: Two-pronged approach for future interventions could be useful; (1) Improving the knowledge and practice among the remaining 20-30% through repeated awareness\u27 sessions for the community. (2) Information regarding PCCS needs to be made readily available to the parents which is a measure useful in cases a child poisoning occurs